Life Transitions: Workforce-to-Retirement Insurance Programs

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As your needs change, so should your coverage.

protectingfamiliesWhen you transition from one stage in your life to the next, there are certain changes you have to consider. Among them is your insurance coverage. Depending on your age and other factors, your coverage options may differ widely. We're here to help you evaluate your changing needs as you prepare.

When do you plan to retire?

Before age 65

If you’re retiring before age 65, you and your covered family members can extend your employer’s health plan in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA). You may also be able to enroll in your spouse’s employer health plan within 31 days of your qualifying loss of coverage, or a non-group health insurance plan through Sylvia Group or through the Massachusetts Health Connector. You should examine all of these options to see which plan(s) can provide you with the medical coverage you need at a cost you can afford.

At age 65

Many people wait until they are 65 to retire so that they can transition from their employer health plan to Medicare at retirement. You can sign up for Medicare during your Initial Enrollment Period, which begins 3 months before you turn 65 and ends 3 months after the month you turn 65. It’s important to know when to sign up and what benefits to sign up for. Otherwise, you may find yourself paying penalties to Medicare as a late enrollee.

Beyond age 65

The normal Social Security retirement age has increased for Americans based on legislation passed by Congress in 1983. Previously, early retirement benefits could start at age 62, with normal retirement benefits starting at age 65. Now, depending on the year you were born, normal retirement age is between ages 66 and 67 and financial incentives provide for even greater benefits by postponing Social Security up to age 70. As a result, many Americans are working well into their 60’s and beyond. Deciding when to retire, and when to start receiving your Social Security benefits, are important considerations which should be reviewed with your financial adviser, your spouse and family, and your employer.

Even though your Social Security benefits eligibility has changed, your Medicare eligibility has not changed. However, there are some rules surrounding your health plan options after age 65. As long as you remain enrolled in your employer’s health insurance plan, you may be able to postpone your enrollment in Medicare until a later date without facing any late enrollment penalties for Medicare. It is important to know how Medicare affects your employer health plan, especially in these circumstances:

If you have an HSA-qualified high deductible health plan (HDHP), and you and/or your employer are making contributions to your Health Savings Account (HSA), you cannot contribute to your HSA once you are enrolled in Medicare. However, you may be able to contribute to your HSA for the calendar year months prior to becoming enrolled in Medicare.

If you postpone enrollment in Medicare and stay on your HSA-qualified employer health plan, you can continue to make contributions to your HSA, but you must cease making contributions six months prior to your enrollment in Medicare. For more information on Medicare and the rules governing your HSA account, contact your HSA bank/administrator, your employer, your tax advisor or your health insurance advisor.

If you are working beyond age 65 and you are enrolled in your employer health plan, your options will differ depending on whether your employer has over 20 employees, in which case your employer plan is primary, and you can defer enrolling in Medicare.

If your employer has less than 20 employees, however, your employer may be exempt from Medicare Secondary Payer rules. In that case, Medicare is considered to be the primary payer. That means that you must enroll in both Part A and Part B Medicare to avoid any late enrollment penalties, and also to avoid gaps in coverage. If you remain on your employer plan, that plan would pay secondary to Medicare. If your employer plan includes prescription coverage that meets minimum standards under Medicare, you may be able to defer enrolling in a Part D prescription plan. Alternately, you may need to purchase a Medicare Supplement or Medicare Advantage plan on your own, including Part D prescription coverage.

There are many complex issues to consider when you work beyond age 65, so be sure to consult with a knowledgeable Medicare adviser.

What about other employment-based insurance benefits?

When you work beyond age 65, medical insurance is not the only benefit that is affected. Many employers who provide employee life insurance will have a scheduled reduction in life insurance amounts after age 65 or age 70. If you continue to work beyond age 65 or 70 and your life insurance benefit is being reduced due to age, you will have the option to convert your previous benefit to an individual policy, as long as you apply for conversion within the specified time in your group life policy. Depending on your health status, and how much life insurance you need, you should consult with a life insurance adviser to help you plan for life insurance needs during your working years and into your retirement years.

You may have disability income protection at work, which is designed to replace a portion of your wages if you are unable to work due to illness or injury. Depending on the type of disability insurance coverage you have, it may be affected by your eligibility for Social Security benefits. Be sure to review your coverage to make sure you know what to expect if you have an illness or injury, especially after your normal retirement age. 

You may also have dental, vision, accident, critical illness/cancer, and long term care insurance through work, either as part of your employer group plan, or as a voluntary benefit you purchased through payroll deductions. Depending on the type of coverage, it may be continued after retirement. Group dental and vision plans qualify for COBRA continuation, while voluntary benefits are often portable and can be continued after retirement by direct payment to the carrier. A knowledgeable insurance broker can help you review your options and recommend the best way to insure your needs after retirement.

If you are retiring, you can use Medicare in addition to a group health plan offered by your former employer.

While Medicare can aid in health care costs, it does not offer coverage for dental, vision, life insurance or travel. Therefore, you should consider all of these products as you transition into your retirement:

Provides health care to indiviudals who are 65 or older, disabled individuals who are entitled to Social Security benefits and people who have end-stage renal disease.

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Provides flexibility in premium payments, death benefits and the savings element of the policy.

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Helps provide for the cost of long-term care beyond a predetermined period that is not covered by health insurance, Medicare or Medicaid. Can include nursing home, assisted living facility, adult day care, or in-home assistance, depending on the policy.

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Coverage for dental care, including preventative and diagnostic care.
Coverage for ongoing vision care expenses such as routine eye exams, prescription glasses and contact lenses.
Coverage for medical expenses, trip cancellation, lost luggage, flight accident and other losses incurred while traveling, either internationally or domestically.
Subsidizes the costs of prescription drugs.
Coverage for medical bills and funeral expenses your loved ones may face after your death.
Move your retirement savings from your current retirement plan into an Individual Retirement Account (IRA). This allows you to keep your savings tax-deferred and typically gives you a broader choice of investments.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives recently retirees and laid off employees the right to choose to temporarily continue their group health benefits provided by their former employer.

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Customized coverage to meet your needs

Because we're an independent agency, we can work with multiple companies to find the policy and design the retirement insurance program that best suits your circumstances.

To speak with a Sylvia Group agent, call us at (508) 742-9247 or click on the button below and submit a simple form.




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